Understanding Your “Frozen Shoulder”

Have you been having shoulder pain? Are you having difficulty reaching your arm overhead? You may be suffering from adhesive Capsulitis; or more commonly referred to as "frozen shoulder." Frozen shoulder has been found to be most common in women ages 40-65 (or even higher in those who have a history of Diabetes or thyroid conditions) and it can develop in several different ways.1 Generally, the condition may occur insidiously (no known cause) or following some type of trauma to your shoulder and can be classified into different stages. 1 In either case, adhesive capsulitis is an inflammatory response that results in the tightening of the joint capsule of your shoulder.

Frozen Shoulder

Stage 1: Pain

  • 0-3 Months
  • Pain during active and passive ROM
  • Mild Limitations of Flex, ABD, IR, ER

Stage 2: Freezing

  • 3-9 Months
  • Chronic pain
  • Significant motion limitations

Stage 3: Frozen

  • 9-15 Months
  • Mild pain, except at end ranges
  • Significant motion loss

Stage 4: Thawing

  • 5-24 Months
  • Mild pain
  • Gradual gains in motion

As you can see, the recovery process for this diagnosis is much longer than what you might think. The good news is that if managed properly, it can help you to reduce the duration of your symptoms. In the past, it was common thought that if your shoulder is stiff you've got to STRETCH, STRETCH, STRETCH. As physical therapists, it's our job to evaluate which stage of the condition you are in and then classify your symptoms into 1 of 3 categories to guide your treatment individually. We look to determine your level of shoulder "irritability" (High, moderate, low) in order to match the best treatments to your current status. Recent information has shown that we will continue to stretch and mobilize your shoulder as had previously been performed, but your level of shoulder irritability will determine whether we hold the stretch for short periods or long period as well as whether we mobilize conservatively or aggressively.1 The condition is common, but how we treat it shouldn't be.

  1. Kelley M, McClure P, Leggin B. Frozen shoulder: evidence and a proposed model guiding rehabilitation. The Journal Of Orthopaedic And Sports Physical Therapy [serial online]. February009;39(2):135-148. Available from: MEDLINE, Ipswich, MA.